ABSTRACT 49

MYOCARDIAL REVASCULARIZATION WITH AND WITHOUT CARDIOPULMONARY BYPASS. IMPACT OF THE STRATEGY ON EARLY  OUTCOME

Antonio M Calafiore, MD, Michele Di Mauro, MD, Stefano D’Alessandro, MD, Marco Pano, MD, Antonio Bivona, MD, Piero Pelini, MD.“G. D’Annunzio” University, Department of Cardiac Surgery, Chieti, ITALY

Background.  The use of cardiopulmonary bypass (CPB) for myocardial revascularization (MR) was evaluated as a potential risk factor for 30 day outcome. The events investigated were death (any cause),  cerebrovascular accidents (CVA), acute myocardial infarction (AMI), and early major events (the sum of death, CVA, AMI, respiratory insufficiency, acute renal failure, low output syndrome, gastrointestinal complications).

Methods and results. All the patients (1912) who had isolated MR via a median sternotomy with (995, 52.0%) and without (917, 48.0%) CPB from May 21, 1997, to October 31, 2000 were evaluated with the stepwise logistic regression. Patients were grouped according intention to treat. A variety of pre and perioperative variables, including CPB, were considered. The explored events had the following incidence: death 2.3%, CVA 0.9%, AMI 1.7%, early major events 6.5%. Results are showed in the table.

AMI, acute myocardial infarction; CRF, chronic renal failure; EF, ejection fraction; IABP, intraaortic balloon pumping; EA, endoarteriectomy.

Conclusion. In patients who undergo isolated MR via a median sternotomy CPB is an independent variable for increased incidence of early death, CVA and early major events.